How consistent innovation is with values, habits, experience, and needs of potential adopters

PCPs have well-established roles in preventive activities such as injury prevention counseling and immunizations. Fluoride varnish can be applied right before vaccines using same space and staff. Overtaxed staff did not want to add 1 more thing to their responsibilities

Complexity

How difficult the innovation is to understand or use

After training, fluoride varnish was perceived as simple and not requiring excessive space or staff time.

Trialability

Extent to which the innovation can be experimented with before committing to adopt

Word of mouth about fluoride varnish was good public relations for 1 practice. Involvement with ABCD has improved access to dental care.

TABLE 2.

Recommendations for Fluoride Varnish Program Planning

The initial message to the PCP should address benefits of fluoride varnish and its cost relative to reimbursement and concerns about time and space.

Reimbursement for fluoride varnish application can be an important motivator. Advocate for this from Medicaid and private insurance in your state.

Ancillary staff must have buy-in and be involved in planning and implementing fluoride varnish. Their important role should be acknowledged in the training and subsequently encouraged.

Training should be hands-on, leave participants positive and enthusiastic, and allow participants to start using fluoride varnish right away. After training is completed, provide ongoing support.

Help practice staff to think through systems needed for fluoride varnish applications and billing. Determine how eligible patients will be identified and approached for fluoride varnish.

Facilitate formal and informal affiliations between MDs and dentists within a community to enhance partnerships, learning opportunities, and dental care referrals.

TABLE 3.

Recommendations for Medical Offices That Are Considering Fluoride Varnish

Get ancillary staff’s support and buy-in. Elicit input on how fluoride varnish can work in your office setting.

Use your front office staff to identify potential fluoride varnish recipients. Mark the chart in an obvious way to designate fluoride varnish eligibility, and incorporate fluoride varnish as an option on preprinted order sheets.

Identify designated time, space, and staff for fluoride varnish application. In younger children, fluoride varnish is usually best done after the PCP’s visit but before vaccines. Make use of other types of visits, such as acute care and sports physicals, for fluoride varnish application to older children.

During your oral examination, assess the child’s teeth and oral hygiene. Use discussion about fluoride varnish as an opportunity to address the importance of preventive oral health and professional dental care. A brief written description of fluoride varnish including its safety, its benefits, how it is applied, and aftercare could be given to families when they arrive for their appointment to save in-depth explanations during the PCP’s visit.

Depending on needs in your community, consider offering fluoride varnish to non-Medicaid families for a small fee.

Explore, develop, and use dental resources in your community to improve access to care for your patients.

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